Routine self-monitoring of blood glucose levels by people with type 2 diabetes who are not taking insulin is an ineffective use of health resources as the modest benefits are outweighed by the significant cost of test strips, suggest 2 studies http://www.cmaj.ca/embargo/cmaj091017.pdf and http://www.cmaj.ca/embargo/cmaj090765.pdf in CMAJ (Canadian Medical Association Journal) www.cmaj.ca .

In Ontario, blood glucose test strips are the third largest cost for the Ontario Public Drug Programs in 2007/08, accounting for $100 million or 3.3% of drug expenditures. Usage of test strips increased by almost 250% from 76,320 people in 1997 to 263,513 people in 2008. Almost 53% of people aged 65 and over with diabetes received diabetes test strips by 2008. Sixty-three per cent of patients not receiving insulin used blood glucose test strips in 2008.

"In light of the overall costs and questionable benefits of blood glucose self-monitoring in many patients, more focused policy decisions regarding test strips have been proposed in several jurisdictions," write Muhammad Mamdani of St. Michael's Hospital in Toronto and coauthors in a study on options to reduce test strip usage. They project that expenditures associated with blood glucose self-monitoring will exceed $1 billion in Canada and suggest policy changes could lead to cost reductions.

This self-testing is also done by those who, by dent of their heritage, are concerned about flipping over into type 2 diabetes.

I have a family history of diabetes. But I am not diabetic, just worried about not being overweight (so far, so good) or encountering from some other factor that might bring on diabetes. So, I test myself from time to time.

The commenters are right, though. Big Government Health Care will see this as something to cut in the future.

What a bunch of morons! There are different types of type 2 and one of them is insulin resistant. My body produces insulin but the body fails to efficiently use it. Insulin will do nothing for insulin resistance. Monitoring is important because without it you don’t know if diet and exercise is working and even for those who take insulin you can’t always tell if the insulin dose is effective. Monitoring blood sugar is how I knew that diet and exercise were no longer working well and that I needed to start taking Metformin to regulate blood sugar through liver function. This is what you get when you let bureaucrats run things.

9
posted on 12/21/2009 10:05:51 AM PST
by RJS1950
(The democrats are the "enemies foreign and domestic" cited in the federal oath)

You are in the same boat as my wife. She was(is) type 2 insulin resistant. She had her A1C down to 4.9 at one point two years ago. She had stopped monitoring her blood glucose because she was doing so well and her doctor (worthless doctor I might add, but that's a different story) said she didn't need to monitor anymore, just do the A1C ONCE A YEAR!?

Now it's back up to 7 on the same diet and exercise and she's kicking herself that she wasn't monitoring her glucose levels. Even once a day would have clued her in there might have been a problem.

I have to pay for my own test strips, so found the Side Kick system at Wally world, cost around $20.00 with 50 strips. I did a month of comparison with the Bayer meter I was using and they were within 2-3 points of each other every time.

My doctor is a military doctor at a military hospital. She always wants to make sure that I track my blood sugar at a minimum twice a day. She and the other doctors I have had there have been great and leave nothing to chance. I’ve had more poking and prodding since retiring from the military than I ever had on active duty. After a military career and 16 years of retirement from the military I have received nothing but top rate care; same for my family. My hope is that it will continue but that hope is dimming. My wife has her primary provider through our workplace and her secondary is Tricare standard. Her coverage is as much in jeopardy as mine. If it comes to a confrontation I am fully ready to take part because I still hold to my oath to defend the Constitution against the Nazi democrat party.

22
posted on 12/21/2009 11:01:09 AM PST
by RJS1950
(The democrats are the "enemies foreign and domestic" cited in the federal oath)

Routine self-monitoring of blood glucose levels by people with type 2 diabetes who are not taking insulin is an ineffective use of health resources...

Is it just me, or are others noticing the pattern? Most of the medical news since the Democrats went over the cliff on medical care is about how preventative medicine is a poor use of resources, and we'd be better off without self monitoring of glucose, without mammograms, without pap smears, and without so many other tests that used to be considered essential back in the days when doctors who cared about patient outcomes made medical decisions. Today, with government bean counters in charge of medicine, we're going to get the "change" that Obama promised.

24
posted on 12/21/2009 11:20:39 AM PST
by Pollster1
(Natural born citizen of the USA, with the birth certificate to prove it)

Interpretation: Many people who self-monitor their blood glucose are at relatively low risk for drug-induced hypoglycemia. The economic benefits associated with more selective testing could be redirected to more effective interventions for patients with diabetes.

IMHO, it's probably a reasonable conclusion, but in this atmosphere poisoned by rat duplicity, you can't have a rational discussion.

I’ve been doing this for a long time although I am not a diagnosed diabetic. I can find some good deals on ebay of unused strips. Just be sure to find some that are not expired or close to expiration. Another tip: The brand sold by Wal-Mart at a fraction of the price of others also gives very good and accurate results and they are also available on ebay.

I think it is just good insurance to keep from tipping into Type II diabetes as it is so common with obesity. And keeping weight off as we age is no easy task.

I don’t believe it is accurate to say that glucophage increases the chance for hypoglycemia. I don’t know about the other med you mention.

The strips are an OTC item and do not require a prescription nor are they required for the lancets. The kits to measure the glucose levels are available most anywhere OTC or on the internet. I’m not sure about the insulin, however as it might be a prescription item.

To get some idea of the savings available, 50 strips of the Ascencia Contour strip which I use retail for about $57 at Wal-Mart. However, I regularly buy them from ebay for perhaps $15-$20. Alternatively, the house brand at Wal-Mart is considerably less retail but highly accurate as I have compared the result alongside one another. It might vary a point or two. The best test result is with the A1C test but that is more expensive and typically done with the blood work-up at the doctor’s office. For the average patient it is much easier to do the test at home.

Oddly enough, the highest readings are often in the morning and are known as the “Dawn phenomenon” and readings taken two hours later after meals will show perfectly normal. There has been much literature on this subject by many sources. One can read up on this and become educated on the actual facts.

Regardless, diabetes is a serious problem and could lead to early death from cardio problems; strokes and heart attacks and possibly blindness as the retina is affected as it also is with high blood pressure. I keep a VERY close watch on both at my age, 66, to ensure I don’t prematurely wear a toe tag or have to get about with a white cane.

I don’t believe it is accurate to say that glucophage increases the chance for hypoglycemia. I don’t know about the other med you mention.

The strips are an OTC item and do not require a prescription nor are they required for the lancets. The kits to measure the glucose levels are available most anywhere OTC or on the internet. I’m not sure about the insulin, however as it might be a prescription item.

To get some idea of the savings available, 50 strips of the Ascencia Contour strip which I use retail for about $57 at Wal-Mart. However, I regularly buy them from ebay for perhaps $15-$20. Alternatively, the house brand at Wal-Mart is considerably less retail but highly accurate as I have compared the result alongside one another. It might vary a point or two. The best test result is with the A1C test but that is more expensive and typically done with the blood work-up at the doctor’s office. For the average patient it is much easier to do the test at home.

Oddly enough, the highest readings are often in the morning and are known as the “Dawn phenomenon” and readings taken two hours later after meals will show perfectly normal. There has been much literature on this subject by many sources. One can read up on this and become educated on the actual facts.

Regardless, diabetes is a serious problem and could lead to early death from cardio problems; strokes and heart attacks and possibly blindness as the retina is affected as it also is with high blood pressure. I keep a VERY close watch on both at my age, 66, to ensure I don’t prematurely wear a toe tag or have to get about with a white cane.

Folks using glipizide and glucophage are at considerable risk of hypoglycemia ~ which makes me think the guy who wrote this article is an idiot and didnt correctly report what he was told.

The danger with insulin is that with the chance of accidentally injecting into a blood vessel, the first symptom you can have is a loss of consciousness.

Oral agents are much more likely to have prior symptoms like breaking into a cold sweat and feeling light headed before that happened. That can happen with insulin too, but those symptoms are warning signs that can be remedied with adding concentrated sugar in orange juice or soda pop.

Years ago those with diabetes had to frequently visit their doctor for testing. The self check strips cut down significantly on doctor visits. I would think the test strips are cheaper than doctor visits. Of course with the new health care plan no one will be able to see the doctor frequently so I guess they will save money. As I see it, if you have diabetes and test strips are not paid for, and you can’t get in to see the doctor regularly to check your glucose then you will likely end up insulin dependendent and of course without proper care you will die sooner. So problem solved, they saved money on you and that is what really counts.

43
posted on 12/21/2009 4:05:36 PM PST
by Tammy8
(Please Support & pray for our Troops; they serve us every day. Veterans are heroes not terrorists!)

Thank you for your service. Hubby is also disabled veteran with diabetes and goes to an Army hospital for care. They have not (yet) limited his strips but the kind he uses are dated and if out of date by even one day will not give a reading. Instead of limiting his strips they give him a lot more than he needs and when they expire they have to be thrown away~ very wasteful. No logic is used with this sort of thing.

44
posted on 12/21/2009 4:12:51 PM PST
by Tammy8
(Please Support & pray for our Troops; they serve us every day. Veterans are heroes not terrorists!)

I don’t know about the strips the VA uses, but hubby gets his strips from an Army hospital and we have tried to buy them elsewhere and no one carries his type of strip. The pharmacists always say no one else has the same type of tester the Army gives patients. In order to buy our own strips we would have to buy a more common type of tester- glucometer or whatever it is called. It is one of the many odd issues with government run healthcare- Army, VA. Coming soon to everyone it seems.

45
posted on 12/21/2009 4:18:00 PM PST
by Tammy8
(Please Support & pray for our Troops; they serve us every day. Veterans are heroes not terrorists!)

The dims said they could cut the cost of waste enough to pay for this boondoggle~ seems it is a waste to do preventative medicine, and many patients/treatments will be deemed an ineffective use of health resources more people will die sooner, all saving money of course. It's part of the grand plan don't you know?

46
posted on 12/21/2009 4:24:33 PM PST
by Tammy8
(Please Support & pray for our Troops; they serve us every day. Veterans are heroes not terrorists!)

I dont know about the strips the VA uses, but hubby gets his strips from an Army hospital and we have tried to buy them elsewhere and no one carries his type of strip. The pharmacists always say no one else has the same type of tester the Army gives patients.

There's the right way, the wrong way and the Army way. Or, in this case, the VA way.

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